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運用決策樹演算法於肝硬化重症病人死亡預測
USING DECISION TREE C4.5 ALGORITHM TO PREDICT THE DEATH OF PATIENTS WITH CIRRHOSIS
摘要
運用決策樹C4.5演算法，找出影響加護病房肝硬化病人是否死亡之關鍵重要因素，以供相關人員參考。材料與方法：採電子病歷回溯性調查設計，以某區域醫院加護病房2013年8月1日至2015年12月31日肝硬化個案287位進行分析，並以自擬結構性調查表收集資料、以SPSS 22.0分析資料及統計，並使用WEKA3.8.2中的決策樹C4.5演算法產生決策規則以了解哪些因素的組合將可預測入住加護病房之肝硬化病人是否死亡。結果：透過配合不同參數之設定與交叉驗證，求得羅吉斯迴歸預測準確度為94.4%，而決策樹C4.5演算法求得預測的準確度為96.5%，並顯示如果病患「APACHE II score ＞28」且「Albumin ＜=3.2」其死亡機率較高，其他規則尚與APACHE II score 、MELD score、Gender、Viral hepatitis、是否已戒酒、Cr、年齡、Bilirubin等有關。結論：決策樹C4.5演算法較羅吉斯迴歸具有較高的正確率且可產生決策規則更適用於探究加護病房肝硬化病人是否死亡之預測。研究結果將有助醫療人員提早掌握肝硬化病人病情進程並提供病人及家屬合宜之治療方針。
並列摘要
Purpose: Decision tree C4.5 algorithm is used to find out the key factors that affect the death of patients with cirrhosis in the intensive care unit for reference. Material and Method: A retrospective investigation is designed with electronic medical records to make an analysis on 287 patients with cirrhosis in the intensive care unit of a regional hospital from August 1, 2013 to December 31, 2015. A self-designed structural survey is made for data collection, and SPSS 22.0 is used for data analysis and statistics. Decision tree C4.5 algorithm of WEKA3.8.2 is used to generate decision rules and understand which combination of the factors will predict the death of the patients with cirrhosis in the intensive unit. Result: By operating the settings of different parameters and cross-validation, the accuracy of Logistic regression prediction is 94.4% but the accuracy of decision tree C4.5 algorithm is 96.5%. It is also shown that the death of rate for patients is higher when their APACHE II score ＞28 and Albumin ＜=3.2. Regarding other rules, APACHE II score, MELD score, gender, viral hepatitis, quitting alcohol, Cr, age and bilirubin should be considered. Conclusion: Decision tree C4.5 has higher accuracy than Logistic repression, and it can produce decision rule which is more suitable to predict whether patients with cirrhosis in the intensive unit are dead. The result of this study will help medical staff handle the condition of patients with cirrhosis early and then provide sufficient treatment for patients and their families.